PURPOSE This article gives an overview of nationwide cancer statistics, including incidence, mortality, survival and prevalence, and their trends in Korea based on 2010 cancer incidence data.
MATERIALS AND METHODS Incidence data from 1993 to 2010 were obtained from the Korea National Cancer Incidence Database, and vital status was followed until 31 December 2011.
Mortality data from 1983 to 2010 were obtained from Statistics Korea. Crude and age-standardized rates for incidence, mortality, prevalence, and relative survival were calculated.
RESULTS In total, 202,053 cancer cases and 72,046 cancer deaths occurred during 2010, and 960,654 prevalent cancer cases were identified in Korea as of 1 January 2011. The incidence of all cancers combined showed an annual increase of 3.3% from 1999 to 2010. The incidences of liver and cervical cancers have decreased while those of thyroid, breast, prostate and colorectal cancers have increased.
Notably, thyroid cancer, which is the most common cancer in Korea, increased by 24.2% per year rapidly in both sexes.
The mortality of all cancers combined showed a decrease by 2.7% annually from 2002 to 2010. Five-year relative survival rates of patients who were diagnosed with cancer from 2006 to 2011 had improved by 22.9% compared with those from 1993 to 1995.
CONCLUSION While the overall cancer incidence in Korea has increased rapidly, age-standardized cancer mortality rates have declined since 2002 and survival has improved.
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PURPOSE To estimate the current cancer burden in Korea, cancer incidence and mortality rates were projected for the year 2013.
MATERIALS AND METHODS Cancer incidence data from 1999 to 2010 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2011 were obtained from Statistics Korea. Cancer incidence in 2013 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was used, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly.
RESULTS In total, 247,732 new cancer cases and 74,179 cancer deaths are projected to occur in Korea in 2013. For all sites combined, the crude incidence rates are projected to be 489.8 and 492.2, and the age-standardized incidences to be 350.4 and 318.4 per 100,000 for males and females, respectively.
CONCLUSION Cancer has become an important public health concern in Korea, and as the Korean population ages, the cancer burden will continue to increase.
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PURPOSE Parameters of positron emission tomography-computed tomography (PET-CT) were compared with the results of histopathologic examination in order to determine which can provide an objective indication of response after neoadjuvant chemoradiation for treatment of thoracic esophageal squamous cell carcinoma (SCC). MATERIALS AND METHODS Between August 2003 and January 2010, data on 25 patients who underwent neoadjuvant chemoradiation and subsequent resection for treatment of esophageal SCC were retrospectively reviewed. Changes in maximum standardized uptake value (DeltaSUVmax), metabolic tumor volume (DeltaMTV), and total lesion glycolysis (DeltaTLG) were analyzed by comparison with the histopathologic findings. RESULTS Pathologic complete remission (CR) for the main tumor was achieved in 11 patients. Postradiation esophagitis was observed in 10 patients. DeltaSUVmax of the main tumor was significantly greater in the CR group than in the partial response (PR) group (p=0.039), while DeltaMTV and DeltaTLG of the main tumor were not (p=0.141 and p=0.349, respectively). The cut-off DeltaSUVmax value for CR was estimated as 72.1%, indicating significantly better accuracy than visual interpretation (p=0.045). Of the 48 involved lymph nodes, DeltaSUVmax and DeltaMTV of lymph nodes were significantly greater in the CR group than in the PR group (p=0.045 and p=0.014, respectively), while DeltaTLG was not (p=0.063). The cut-off value of DeltaSUVmax for prediction of CR in lymph nodes was calculated as 50.67%. CONCLUSION PET-CT could be used for prediction of response to neoadjuvant treatment in thoracic esophageal SCC.
DeltaSUVmax may be a more significant predictor for CR after neoadjuvant chemoradiation than DeltaTLG and DeltaMTV.
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PURPOSE We wanted to evaluate the role of postoperative chemoradiotherapy (CRT) for patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). MATERIALS AND METHODS From March 1993 to July 2008, 101 patients with advanced SCCHN and who had undergone macroscopically complete resection were enrolled. Survival and the cumulative incidence of local or regional relapse, metastasis, and acute toxicity were analyzed. RESULTS There was a marginally significant difference of disease-free survival at five years in favor of the CRT arm (51.3% vs. 41.8%, respectively; p=0.10). However, there was no significant difference in overall survival between the two treatment arms (p=0.20). The rate of locoregional failure only for the radiotherapy arm was significantly higher than that for the CRT arm (23.2% vs. 4.4%, respectively; p=0.01). The incidence of grade 3 or 4 hematologic toxicity was significantly higher in the CRT arm than that in the radiotherapy arm (37.7% vs. 1.7%, respectively; p=0.01). In CRT arm, early mortality group within 1 year had low performance status and old age over sixty compared with those of the others. CONCLUSION After curative-intent surgery, adjuvant CRT is more effective in locoregional tumor control than radiotherapy alone for patients with advanced SCCHN.
However, compared with radiotherapy alone, this combined modality treatment had no survival benefit, and was significantly associated with increased toxicity. Thus, patients with low performance status and old age must be cautious in selection of toxic trimodality treatment.
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PURPOSE The purpose of this study is to evaluate the efficacy and toxicity of oxaliplatin, leucovorin, and 5-fluorouracil (FOLFOX-4) chemotherapy in heavily pretreated patients with recurrent epithelial ovarian cancer (EOC). MATERIALS AND METHODS Clinical data were reviewed in 28 patients who received FOLFOX-4 as more than the second-line chemotherapy, consisting of 85 mg/m2 of oxaliplatin as a 2-hour infusion, 200 mg/m2 of leucovorin as a 2-hour infusion, and bolus 400 mg/m2 on day 1, followed by a 22-hour infusion of 600 mg/m2 of 5-fluorouracil for two consecutive days every three weeks. In addition, its efficacy and toxicity were compared with those reported in in three previous relevant studies. RESULTS A total of 128 cycles of FOLFOX-4 were administered with the median number of five cycles (range, 1 to 10 cycles). In nine patients with measurable disease, complete response (CR) and partial response (PR) were observed in 0 (0%) and two (22.2%) patients, whereas in 19 patients with non-measurable disease, CR and PR were observed in 0 (0%) and five (26.3%) patients. Among all patients, grade 3 anemia, neutropenia, and thrombocytopenia were observed in two (7.1%), three (10.7%), and one (3.6%) patient, and grade 3 fatigue, nausea and vomiting, and peripheral neuropathy were observed in one (3.6%), two (7.1%), and three (10.7%) patients. In addition, median values of time to progressive disease and chemotherapy-specific survival were three months (range, 0 to 10 months) and nine months (range, 4 to 24 months). CONCLUSION FOLFOX-4 is feasible as salvage chemotherapy with acceptable toxicity for heavily pretreated patients with recurrent EOC.
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PURPOSE In some unusual cases, in patients with cervical cancer, an elevation of squamous cell carcinoma antigen (SCC-Ag) was not observed at diagnosis but was observed on recurrence, or vice versa. The objective of this study was to identify patient-, disease-, and treatment-related factors associated with this unusual level of SCC-Ag, and to determine whether SCC-Ag is a useful tumor marker in such patients. MATERIALS AND METHODS Among 129 patients with recurrence, 14 who showed a normal SCC-Ag level at diagnosis but an elevated level at recurrence were classified as group I; 22 patients with an elevated SCC-Ag level at diagnosis but not at recurrence were classified as group II; and 76 patients with an elevated SCC-Ag level at both diagnosis and recurrence were classified as group III. RESULTS In univariate analysis, unusual SCC-Ag showed statistically significant relationships with pathology and biochemical response to treatment. However, in the multivariate analysis, none of the clinicopathologic factors showed a statistical relationship with unusual levels of SCC-Ag. The 5-year disease-free survival rates for groups I, II, and III were 7.1%, 9.1%, and 0% (p=0.418), and the 5-year overall survival rates were 34.3%, 58.4%, and 33.3% (p=0.142), respectively. CONCLUSION The value of SCC-Ag has been confirmed in all patients; thus, check of SCC-Ag level at follow-up should be considered. Although no statistically significant differences were observed among the groups, we conclude that patients with a high initial SCC-Ag and elevated SCC-Ag at relapse have poor prognosis due to high SCC-Ag level.
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Can serial evaluation of serum SCC-Ag-level predict tumor recurrence and patient survival in squamous-cell carcinoma of uterine cervix treated with definitive chemoradiotherapy? A multi-institutional analysis Kyu Hye Choi, Mina Yu, Songmi Jeong, Jong Hoon Lee International Journal of Clinical Oncology.2020; 25(7): 1405. CrossRef
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Significance of elevated SCC-Ag level on tumor recurrence and patient survival in patients with squamous-cell carcinoma of uterine cervix following definitive chemoradiotherapy: a multi-institutional analysis Kyu Hye Choi, Sea-Won Lee, Mina Yu, Songmi Jeong, Jeong Won Lee, Jong Hoon Lee Journal of Gynecologic Oncology.2019;[Epub] CrossRef
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The association between serum squamous cell carcinoma antigen and recurrence and survival of patients with cervical squamous cell carcinoma: A systematic review and meta-analysis Chuenkamon Charakorn, Kunlawat Thadanipon, Sawarat Chaijindaratana, Sasivimol Rattanasiri, Pawin Numthavaj, Ammarin Thakkinstian Gynecologic Oncology.2018; 150(1): 190. CrossRef
Squamous cell carcinoma antigen expression in tumor cells is associated with the chemosensitivity and survival of patients with cervical cancer receiving docetaxel-carboplatin-based neoadjuvant chemotherapy Peng Chen, Liang Jiao, Dan-Bo Wang Oncology Letters.2017; 13(3): 1235. CrossRef
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PURPOSE Activating mutation of the KRAS oncogene is an established negative predictor for anti-epidermal growth factor receptor (anti-EGFR) therapies in metastatic colorectal cancer (CRC). However, KRAS mutation as a prognostic factor of survival outcome remains controversial in CRC, independent of anti-EGFR therapies. MATERIALS AND METHODS We conducted a retrospective analysis of 103 CRC patients who were available for evaluation of KRAS mutation status. None of the patients analyzed had received anti-EGFR therapies. The role of KRAS mutation status was evaluated as a predictive factor for oxaliplatin or irinotecan and as a prognostic factor in CRC patients who did not receive anti-EGFR therapies. RESULTS Mutations in KRAS were observed in 48.5% of patients. The response for oxaliplatin- (p=0.664) and irinotecan-based (p=0.255) cytotoxic chemotherapy did not differ according to the KRAS mutation status. In addition, no significant difference in progression free survival (PFS; oxaliplatin, p=0.583 and irinotecan, p=0.426) and overall survival (OS; p=0.258) was observed between the wild and mutant type of the KRAS gene. In univariate and multivariate analyses, KRAS mutations did not have a major prognostic value regarding PFS (oxaliplatin: hazard ratio, 0.892; 95% confidence interval [CI], 0.590 to 1.347; p=0.586 and irinotecan: hazard ratio, 0.831; 95% CI, 0.524 to 1.319; p=0.433) or OS (hazard ratio, 0.754; 95% CI, 0.460 to 1.236; p=0.263). In addition, anti-vascular endothelial growth factor therapies did not affect PFS to oxaliplatin or irinotecan and OS. CONCLUSION KRAS mutation is not a prognostic marker for PFS to oxaliplatin or irinotecan and OS in CRC patients who did not receive anti-EGFR therapies.
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PURPOSE There are three types of bile duct cancer, intrahepatic cholangiocarcinoma (ICC), hilar cholangiocarcinoma (HC), and extrahepatic cholangiocarcinoma (EHC). Despite different clinical presentation, the same protocol has been used in treatment of patients with these cancers. We analyzed clinicopathologic findings and protein expression in order to investigate the difference and the specific prognostic factors among these three types of cancers. MATERIALS AND METHODS We conducted a retrospective review of 104 patients diagnosed with bile duct cancer at Seoul St.
Mary's Hospital between January 1994 and May 2004. We performed immunohistochemical staining for p53, cyclin D1, thymidine phosphorylase, survivin, and excision repair cross-complementing group 1 (ERCC1). RESULTS Of the 104 patients, EHC was most common (44.2%).
In pathologic findings, perineural invasion was significantly less common in ICC. Overall survival was similar among the three types of cancer. Lymph node invasion, lymphatic, and venous invasion showed a significant association with survival outcome in ICC, however, the differentiation of histologic grade had prognostic significance in HC and EHC. No difference in protein expression was observed among these types of cancer, however, ERCC1 showed a significant association with survival outcome in HC and EHC, not in ICC. CONCLUSION Based on our data, ICC showed different characteristics and prognostic factors, separate from the other two types of bile duct cancer. Conduct of further studies with a large sample size is required in order to confirm these data.
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Paraneoplastic pemphigus is an autoimmune blistering and erosive mucocutaneous syndrome associated with underlying neoplasm. It is primarily associated with lymphoproliferative disorders, and uncommonly with malignancies of epithelial origin. We report on a case of a 68-year-old male who presented with whole body bullous and erosive skin lesions. Findings on upper gastrointestinal endoscopy and skin biopsy revealed esophageal squamous cell carcinoma and paraneoplastic pemphigus. Palliative chemotherapy and systemic glucocorticoid were started, however, the patient died of overwhelming sepsis on the ninth day of chemotherapy. This case demonstrates that paraneoplastic pemphigus can occur in esophageal squamous cell carcinoma and could be a cause of morbidity.
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